Key points
- The Timed Up and Go (TUG) times a patient rising from a chair, walking 3 meters, turning, walking back, and sitting.
- The CDC STEADI sheet treats 12 seconds or longer as a fall-risk indicator in older adults.
- Evidence suggests the TUG shouldn't be used alone to predict falls; it's one piece of a fall-risk assessment.
A classic for good reason
The Timed Up & Go (TUG) is deceptively simple: a patient rises from a chair, walks three meters, turns, walks back, and sits. Podsiadlo and Richardson (1991) introduced the timed version and found the score reliable between and within raters, correlated with balance, gait speed, and activities of daily living, and quick enough to fit a routine exam. One number — the time it takes — captures a great deal about mobility and functional independence. Its simplicity is exactly why it's used everywhere, from busy clinics to research studies, and why the CDC includes it in its STEADI fall-risk toolkit.
It's worth being precise about what that number can and can't do. Early work suggested the TUG could separate fallers from non-fallers (Shumway-Cook et al., 2000), but a later systematic review and meta-analysis concluded it has limited ability to predict falls in community-dwelling older adults and shouldn't be used in isolation for that purpose (Barry et al., 2014). For scoring, the CDC's STEADI assessment sheet notes that an older adult who takes 12 seconds or longer to complete the TUG is at risk for falling, and suggests observing postural stability, gait, stride length and sway during the test. It's a valuable piece of the picture, not the whole of it. (Published reference values and cut-offs are collected in our functional test reference values.)
What a single number leaves out
But the total time hides the story inside the movement. Two patients can post the same TUG time while struggling in completely different ways — one slow to stand, another hesitant in the turn, a third unsteady on the return walk. The headline number tells you that something changed; it doesn't tell you what or why, which is what actually guides treatment.
Adding detail without losing simplicity
Objective capture preserves the test clinicians already trust while breaking it into its component phases: the sit-to-stand, the gait out, the turn, and the return. Researchers have shown the value of this approach with body-worn sensors: an instrumented TUG detected differences in cadence, arm swing, and turning between people with early Parkinson's disease and matched controls that the stopwatch time alone did not (Salarian et al., 2010). Each phase becomes its own measurable signal. The clinician still runs the same familiar test, but now the result points to the specific element of mobility that needs work, rather than a single undifferentiated time.
Consistency makes the comparison real
As with any measure, the value comes from comparing it over time, which requires the test to be performed and recorded the same way each visit. Standardized, objective capture removes the small inconsistencies of manual timing and observation. The TUG doesn't need to be replaced — it needs to be resolved at higher fidelity, so the insight it already offers becomes sharper and more actionable.
Our guide to clinical movement assessment tests shows where the TUG fits alongside gait speed, sit-to-stand and balance tests.
References
- Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society. 1991;39(2):142-148. doi:10.1111/j.1532-5415.1991.tb01616.x
- Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Physical Therapy. 2000;80(9):896-903. doi:10.1093/ptj/80.9.896
- Barry E, Galvin R, Keogh C, Horgan F, Fahey T. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatrics. 2014;14:14. doi:10.1186/1471-2318-14-14
- Salarian A, Horak FB, Zampieri C, Carlson-Kuhta P, Nutt JG, Aminian K. iTUG, a sensitive and reliable measure of mobility. IEEE Transactions on Neural Systems and Rehabilitation Engineering. 2010;18(3):303-310. doi:10.1109/TNSRE.2010.2047606
- Centers for Disease Control and Prevention. STEADI assessment: Timed Up & Go (TUG). cdc.gov